October is Breast Cancer Awareness Month.
The constant societal attention to breasts has a very real downside. It has been the cause of women with a breast lump, wasting time in denial, rather than getting a diagnosis and treatment. The tragic irony is this delay lets the disease progress, which can make the treatment more invasive.
Breast cancer is a lot of things, but it is unique in being perceived as an attack on womanhood. That is somewhat perverse, even ridiculous, because cancers of the uterus, cervix and ovary have real potential for reproductive impact, but breast cancer does not.
My family is keenly aware that this is Breast Cancer Awareness Month. I have teenage daughters, breast cancer history in the family (my mom), and 30 years of medicine for perspective.
There will be almost a quarter million new cases of breast cancer in the U.S. this year. On average, about 90 percent of these new cases will be five-year survivors. Sadly, 40,000 women will lose their fight to breast cancer. Everyone will be touched somehow, someplace by this disease – my family certainly has.
There has been a sea of change in breast cancer treatment in the three decades I have been in practice. A male surgical associate recently told me no male could ever understand what looking in the mirror was like for a woman after mastectomy. There simply is no male counterpart.
Most breast cancer surgery in top institutions is now done by fellowship-trained female surgeons. The surgical care of breast cancer has evolved considerably in the last 25 years. We don’t open knees to fix cartilage damage anymore, we get better results with less invasive arthroscopy.
Breast surgery has similarly evolved. If the lump is the problem, in many cases just the lump is removed, and other treatments finish the job. The cure rates are as good as, or better than, the “big operations” we used to do.
Research has provided a steady stream of new treatments, new approaches to prevention, and less invasive but more effective treatments.
Team work has become the norm in many institutions for breast cancer. The breast surgeon, radiation oncologist, medical oncologist, immunology expert, dietitian, mental health professional, and most importantly the patient, all have significant roles to play in successfully treating breast cancer.
This is all intended to get the best individual plan/outcome for that particular patient. Some patients find being treated by a virtual gaggle of doctors somewhat unnerving. The mental health professional can help with that.
In the battle against breast cancer, hard won progress has been made. In the last 25 years, breast cancer mortality has decreased 34 percent. The five-year survival rate has steadily climbed from 75 percent to just over 90 percent. The genetic basis for a few (15 percent) breast cancers has been found.
And much of that progress is thanks to a few talented people figuring out that breast cancer could be a successful brand. In our society, this attracted energy, funding, research priority, and talent.
A couple of days ago my teenage daughter asked me her options for avoiding breast cancer, because she’s aware that Grandma had it. Since I didn’t have good answers for her, that means the fight must continue.
Donald Bucklin, MD (Dr. B) is a Regional Medical Director for U.S. HealthWorks and has been practicing Clinical Occupational Medicine for more than 25 years. Dr. B works in our Scottsdale, Arizona clinic.
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